Prophylactic role of epidural saline injection for post dural puncture headache: a pilot study

This pilot study was designed to judge the prophylactic role of epidural saline injection for prevention of post dural puncture headache [PDPH] in patients with accidental dural puncture during the setting up of epidural anaesthesia. Ten patients who sustained accidental dural puncture during the setting up of epidural anaesthesia. Ten patients who sustained accidental dural puncture during routine epidural anaesthesia for various gynaecological and obstetrical surgical procedures carried out in Gynae Block of Services Hospital Lahore between 16-03-05 to 15-04-06 were included in the study. All patients had ASA I to ASA III status. The age range was 25 to 50 years and weight range was 45 to 70. Kg. A 16 gauge Touhy needle was used for epidural anaesthesia. In case of dural puncture, epidural anaesthesia was given one space above or below the site of puncture. The study was approved by hospital ethical committee. After completion of surgery, 30 ml of normal saline [0.9%] was injected in the epidural space. All patients were observed for three days for occurrence of post dural puncture headache. Two out of ten patients [20%] complained of post dural puncture headache. One patient had to undergo repeat surgery under general anaesthesia for a surgical complication but did not complain of post dural puncture headache. Prophylactic epidural saline injection is associated with low frequency of post dural puncture headache in patients with accidental dural puncture during setting up of epidural anaesthesia